Details: Create Your Own Case Study Discussion Forum (Create my Case study on GI disturbances)
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Topic: NSG 430: Critical Care Nursing
Details: Create Your Own Case Study Discussion Forum (Create my Case study on GI disturbances)
Initial Post: For this discussion board post, you are to pick one topic that we have covered so far (ex: GI disturbances, arrhythmia, etc.). You will create a case study or scenario revolving around this topic. You will need to come up with a patient, their history/situation, and their clinical presentation. You can include any information that will help your reader understand what is going on with the patient. You should use references about the topic to help you create the situation. Then ask three questions, that you would like one of your colleagues to answer regarding your case study/scenario. These questions should be open-ended and allow for critical thinking. Please use the textbook or E-book (Introduction to Critical Care Nursing (8th ed.). St. Louis, Missouri: Elsevier by Sole, M. L., Klein, D. G., Moseley, M. J., Flynn-Magic, M. B., & Morata)
Follow this example please: Case Study Scenario
A 65-year-old Caucasian female is brought into the emergency department late on Monday night. She is complaining of fatigue, lack of appetite, swelling in her legs, feet, and hands, shortness of breath, and dyspnea (American Heart Association, 2017). Her husband called for an ambulance due to the worsening of her symptoms. Once at the emergency department, she is asked what medications she is on and she replies she takes 1000 mg of metformin once a day which she usually takes at night with her dinner and 127.5 mcg of levothyroxine a day (Mayo Clinic, 2021). She reports taking these to help control her type 2-diabetes and hypothyroidism. This is the extent of her known medical history.
She currently lives with her husband and their dog on a 28-acre horse farm where she helps to care for the horses, though recently she had felt short of breath and is experiencing dyspnea while completing the chores. She and her husband have 2 sons who come and help with maintaining the farm 3 days a week.
She is taken into triage where she can be assessed and have her vital signs taken.
She has a heart rate which is 135 beats per minute and that is irregularly irregular (Sole et al., 2021, p. 129). Her respiratory rate is 24, her oral temperature is 98.6 degrees Fahrenheit, her SpO2 is 94 percent on room air, and her blood pressure is 90/60 mm Hg. She currently weighs 165 pounds or 75 kg and is five feet and 3 inches tall.
During her assessment edema is noted in her hands, feet, and legs but it is non-pitting. When asked to rate her pain on a scale of 0 to 10, 0 being no pain and 10 being the worst pain, she reports that her pain is a 2 out of 10. All other aspects of her assessment are within the defined limits.
At the completion of her assessment, the physician puts in an order for a 12 lead electrocardiogram (ECG) to be completed for further evaluation.
Questions
1. What type of dysrhythmia do you think the ECG will show?
2. Based on the diagnosed/identified dysrhythmia what type of treatment plan will most likely be initiated for this patient?
3. Does her hypothyroidism and type 2-diabetes contribute to the formation of her identified dysrhythmia?
References
Drug and Supplements: Levothyroxine (oral route). (2021). In Mayo Clinic. https://www.mayoclinic.org/drugs/levothyroxine-oral/drg-20072133?p=1
Drug and Supplements: Metformin (oral route). (2021). In Mayo Clinic. https://www.mayoclinic.org/drugs-supplements/metformin-oral-route/proper-use/drg-20067074
Sole, M. L., Klein, D. G., Moseley, M. J., Flynn-Makic, M. B., & Morata, L. T. (2021). Introduction to Critical Care Nursing (8th ed.). St. Louis, Missouri: Elsevier.
Warning signs of heart failure. (2017). In American Heart Association. https://www.heart.org/en/health-topics/heart-failure/warning-signs-of-heart-failure
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